    <?php
/**
 * Magento
 *
 * NOTICE OF LICENSE
 *
 * This source file is subject to the Academic Free License (AFL 3.0)
 * that is bundled with this package in the file LICENSE_AFL.txt.
 * It is also available through the world-wide-web at this URL:
 * http://opensource.org/licenses/afl-3.0.php
 * If you did not receive a copy of the license and are unable to
 * obtain it through the world-wide-web, please send an email
 * to license@magentocommerce.com so we can send you a copy immediately.
 *
 * DISCLAIMER
 *
 * Do not edit or add to this file if you wish to upgrade Magento to newer
 * versions in the future. If you wish to customize Magento for your
 * needs please refer to http://www.magentocommerce.com for more information.
 *
 * @category   design_blank
 * @package    Mage
 * @copyright  Copyright (c) 2008 Irubin Consulting Inc. DBA Varien (http://www.varien.com)
 * @license    http://opensource.org/licenses/afl-3.0.php  Academic Free License (AFL 3.0)
 */
?>
<?php
/**
 * Create account form template
 *
 * @see Mage_Customer_Block_Form_Register
 */
?>
<div class="account-create">
    <div class="page-title">
        <h2><?php echo $this->__('Create an Account') ?></h2>
    </div>
    <?php echo $this->getMessagesBlock()->getGroupedHtml() ?>
    <form action="<?php echo $this->getPostActionUrl() ?>" method="post" id="form-validate">
        <fieldset>
        <input type="hidden" name="success_url" value="<?php echo $this->getSuccessUrl() ?>" />
        <input type="hidden" name="error_url" value="<?php echo $this->getErrorUrl() ?>" />
            <h3><?php echo $this->__('Personal Information') ?></h3>
            <ul class="form-list group-select">
                <li>
                    <?php echo $this->getLayout()->createBlock('customer/widget_name')->setObject($this->getFormData())->toHtml() ?>
                </li>
                <li>
                    <div class="input-box">
                        <label for="email_address"><?php echo $this->__('Email Address') ?> <span class="required">*</span></label><br />
                        <input type="text" name="email" id="email_address" value="<?php echo $this->htmlEscape($this->getFormData()->getEmail()) ?>" title="<?php echo $this->__('Email Address') ?>" class="input-text validate-email required-entry" />
                    </div>
                </li>
                <?php if ($this->isNewsletterEnabled()): ?>
                <li>
                    <input type="checkbox" name="is_subscribed" title="<?php echo $this->__('Sign Up for Newsletter') ?>" value="1" id="is_subscribed"<?php if($this->getFormData()->getIsSubscribed()): ?> checked="checked"<?php endif; ?> class="checkbox" />
                    <label for="is_subscribed"><?php echo $this->__('Sign Up for Newsletter') ?></label>
                </li>
                <?php endif ?>
            <?php $_dob = $this->getLayout()->createBlock('customer/widget_dob') ?>
            <?php if ($_dob->isEnabled()): ?>
                <li><?php echo $_dob->setDate($this->getFormData()->getDob())->toHtml() ?></li>
            <?php endif ?>
            <?php $_taxvat = $this->getLayout()->createBlock('customer/widget_taxvat') ?>
            <?php if ($_taxvat->isEnabled()): ?>
                <li><?php echo $_taxvat->setTaxvat($this->getFormData()->getTaxvat())->toHtml() ?></li>
            <?php endif ?>
            </ul>
        </fieldset>
    <?php if($this->getShowAddressFields()): ?>
        <fieldset>
            <input type="hidden" name="create_address" value="1" />
            <h3><?php echo $this->__('Address Information') ?></h3>
            <ul class="form-list group-select">
                <li>
                <?php /* Disable Company input
                    <div class="input-box">
                        <label for="company"><?php echo $this->__('Company') ?></label><br />
                        <input type="text" name="company" id="company" value="<?php echo $this->htmlEscape($this->getFormData()->getCompany()) ?>" title="<?php echo $this->__('Company') ?>" class="input-text" />
                    </div>
                    */ ?>
                    <div class="input-box">
                        <label for="telephone"><?php echo $this->__('Telephone') ?> <span class="required">*</span></label><br />
                        <input type="text" name="telephone" id="telephone" value="<?php echo $this->htmlEscape($this->getFormData()->getTelephone()) ?>" title="<?php echo $this->__('Telephone') ?>" class="input-text required-entry" />
                    </div>
                </li>
                <li>
                    <label for="street_1"><?php echo $this->__('Street Address') ?> <span class="required">*</span></label><br />
                    <input type="text" name="street[]" value="<?php echo $this->htmlEscape($this->getFormData()->getStreet(1)) ?>" title="<?php echo $this->__('Street Address') ?>" id="street_1" class="input-text required-entry" />
                </li>
            <?php for ($_i=2, $_n=$this->helper('customer/address')->getStreetLines(); $_i<=$_n; $_i++): ?>
                <li>
                    <input type="text" name="street[]" value="<?php echo $this->htmlEscape($this->getFormData()->getStreet($_i)) ?>" title="<?php echo $this->__('Street Address '.$_i) ?>" id="street_<?php echo $_i?>" class="input-text" />
            <?php endfor ?>
                </li>
                <li>
                    <div class="input-box">
                        <label for="city"><?php echo $this->__('City') ?> <span class="required">*</span></label><br />
                        <input type="text" name="city" value="<?php echo $this->htmlEscape($this->getFormData()->getCity()) ?>" title="<?php echo $this->__('City') ?>" class="input-text required-entry" id="city" />
                    </div>
                    <div class="input-box">
                        <label for="region_id"><?php echo $this->__('State/Province') ?> <span class="required">*</span></label><br />
                        <select id="region_id" name="region_id" title="<?php echo $this->__('State/Province') ?>" class="validate-select" style="display:none;">
                            <option value=""><?php echo $this->__('Please select region, state or province') ?></option>
                        </select>
                        <script type="text/javascript">
                            $('region_id').setAttribute('defaultValue',  "<?php echo $this->getFormData()->getRegionId() ?>");
                        </script>
                        <input type="text" id="region" name="region" value="<?php echo $this->htmlEscape($this->getRegion()) ?>" title="<?php echo $this->__('State/Province') ?>" class="input-text" style="display:none;" />
                    </div>
                </li>
                <li>
                    <div class="input-box">
                        <label for="zip"><?php echo $this->__('Zip/Postal Code') ?> <span class="required">*</span></label><br />
                        <input type="text" name="postcode" value="<?php echo $this->htmlEscape($this->getFormData()->getPostcode()) ?>" title="<?php echo $this->__('Zip/Postal Code') ?>" id="zip" class="input-text validate-zip-international required-entry" />
                    </div>
                    <div class="input-box">
                        <label for="country"><?php echo $this->__('Country') ?> <span class="required">*</span></label><br />
                        <?php echo $this->getCountryHtmlSelect() ?>
                    </div>
                </li>
            </ul>
            <input type="hidden" name="default_billing" value="1" />
            <input type="hidden" name="default_shipping" value="1" />
        </fieldset>
    <?php endif; ?>
        <fieldset>
            <h3><?php echo $this->__('Login Information') ?></h3>
            <ul class="form-list group-select">
                <li>
                    <div class="input-box">
                        <label for="password"><?php echo $this->__('Password') ?> <span class="required">*</span></label><br />
                        <input type="password" name="password" id="password" title="<?php echo $this->__('Password') ?>" class="input-text required-entry validate-password" />
                    </div>
                    <div class="input-box">
                        <label for="confirmation"><?php echo $this->__('Confirm Password') ?> <span class="required">*</span></label><br />
                        <input type="password" name="confirmation" title="<?php echo $this->__('Confirm Password') ?>" id="confirmation" class="input-text required-entry validate-cpassword" />
                    </div>
                </li>
            </ul>
        </fieldset>
        <p class="required"><?php echo $this->__('* Required Fields') ?></p>
        <div class="buttons-set">
            <a href="<?php echo $this->getBackUrl() ?>" class="back-link">&laquo; <?php echo $this->__('Back') ?></a>
            <button class="button" type="submit"><span><?php echo $this->__('Submit') ?></span></button>
        </div>
    </form>
    <script type="text/javascript">
    //<![CDATA[
        var dataForm = new VarienForm('form-validate', true);
        <?php if($this->getShowAddressFields()): ?>
        new RegionUpdater('country', 'region', 'region_id', <?php echo $this->helper('directory')->getRegionJson() ?>);
        <?php endif; ?>
    //]]>
    </script>
</div>
